Provider Demographics
NPI:1740748771
Name:GARZA, JESUS JR
Entity Type:Individual
Prefix:
First Name:JESUS
Middle Name:
Last Name:GARZA
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60028
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78466-0028
Mailing Address - Country:US
Mailing Address - Phone:361-851-0355
Mailing Address - Fax:361-334-2510
Practice Address - Street 1:5151 FLYNN PKWY STE 412G
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-4367
Practice Address - Country:US
Practice Address - Phone:361-851-0355
Practice Address - Fax:361-334-2510
Is Sole Proprietor?:No
Enumeration Date:2019-03-08
Last Update Date:2019-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146M00000XEmergency Medical Service ProvidersEmergency Medical Technician, Intermediate